Start Date
First Name
Last Name
Phone
Cell phone*
Home Address (Pick up location)
E-Mail Address
Payment Method (Select one)*
Cash Check Money Order
Comments or questions? *

a (*) means that field is optional.
Terms: 1.) The $290 fee is NOT refundable for any reason. 2.) Full payment is due with this completed application. 3.) One Milford Wash and Storage bag will be issued per application. 4.) If service is renewed, a new bag will not be granted unless needed. 5.) Additional bags per week are available for an additional charge. 6.) Additional laundry will not be taken unless previous arrangements and payment have been made. 7.) $35 returned check fee.